Currently, the relationship between doctors and pharmaceutical companies is being examined closely and legislators are looking for ways to regulate it, given the medical profession and the pharma industry’s complete failure in doing so themselves. Up to now, the reliable and comprehensive information regarding the nature of the pharma industry sponsorship of doctors has been uncommon, thus, the US Congress is looking for ways to reveal the nature of their relationships.
Australia was one of the first countries to establish a code for greater transparency. Australia’s pharmaceutical industry representative body, Medicines Australia, has a self-regulatory Code of Conduct that establishes the standards for ethical marketing and promotion of the products of its member companies. Even though Australia is a good example of the path to follow, its disclosure requirements are not enough.
Australia’s code centers on monitoring the level and type of sponsorship of educational events instead of on documenting the monetary value of gifts and other payments to physicians. In addition, it doesn’t encompass information about the educational value of sponsored events. In the U.S., the disclosure has to dig deeper.
Medicines Australia’s information shows a high level of contact between pharma manufacturers and doctors and suggests that companies generally do influence the educational content of events that are attended by doctors in training. Students may be easily influenced; they are led to believe that certain pharmaceutical companies are the best for their medical field. It has been proven that the attendance to these events changes the prescribing practices, and that it is highly affordable to sponsor such events, which provide a high return on investment.
It is necessary to observe the broader view of the interactions between the pharma industry and doctors, including face-to-face contact with representatives, advertising in medical journals, consultancies, membership to advisory boards, and stock holding. Extravagant gifts and travel aid have been the center of attention in the past; however, these have been inhibited by the industry and professional codes. Now we are seeing that regular, more modest, sponsored events may become more influential, and the main point of contact between pharma and doctors.
The Australian information is quite difficult to access. Summary reports listing each function should be easily accessible to the public in a searchable, downloadable, and analyzable format.
Here is a list of the elements that should be included in every effective disclosure program for the pharmaceutical industry in line with the recent Institute of Medicine Report on conflicts of interest:
– Number of attendees at a sponsored event and their professional status
– Venue and description of the function
– Nature of any hospitality provided
– Total cost of hospitality and the function
– Nature of any entertainment provided
– Duration of the educational content of events
– Continuing professional development and medical education points provided
– Nature of any gifts provided
– Names of the speakers
– Dollar value of honoraria and travel aid provided to speakers
– Disclosure of other financial ties between sponsoring companies and speakers
– Role of the company in suggesting or selecting the educational topic and speaker
– Brand names of drugs discussed in the event
As pharmaceutical consulting firms will argue, the intention is not to ban contact between pharma companies and doctors but make their relationship transparent and legitimate, in the best interest of the patient.
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